Therapist Chatbots: Top Use Cases & Challenges in 2025

The World Health Organization (WHO) reports that one in eight people globally suffers from a mental disorder, impacting about 970 million individuals.

Furthermore, approximately 70% of those with mental health issues do not receive treatment across the globe.¹

Therapist chatbots can help bridge the mental health treatment gap, fostering a happier society.

We have compiled use cases, real-life examples, developer challenges, and best practices on how therapist chatbots can help address mental health issues.

Top 5 use cases of therapy chatbots

Figure 1. Top 5 use cases of therapy chatbots

1. Patient onboarding

Access to mental health services often encounters delays because of the necessary but lengthy administrative processes involved in patient onboarding. Today, therapy chatbots streamline this entire procedure by collecting essential patient information, conducting structured intake interviews, and promptly confirming required paperwork.

Given the current provider shortages and extensive waiting lists, this automation ensures that patients receive quicker and more reliable access to mental health support, significantly reducing the administrative burden on healthcare providers. 

Real-life example

Modern onboarding bots can assess the severity of initial symptoms, identify immediate risk factors, and automatically guide patients to the appropriate level of care, which may include self-help modules or urgent professional assistance. 

2. Diagnosis of the illness

Standardized mental health evaluations are conducted by therapy chatbots, which also guide patients toward the appropriate levels of care. Considering that mild-to-moderate symptoms are present in about 75% of mental health situations and can be addressed by digital interventions, this triage method proves particularly beneficial.

Chatbots effectively enhance the healthcare system’s capacity to manage provider shortages by handling early evaluations and lower-acuity situations, thereby freeing limited mental health specialists to focus their expertise on complex cases needing clinical intervention. 

Real-life example:

Chatbots assess symptom severity and identify risk factors using approved screening tools rather than making formal diagnoses, which require certified clinicians. They automatically escalate cases that show signs of severe psychiatric conditions, suicidal ideation, or crisis situations to human professionals while also effectively assisting patients with mild-to-moderate symptoms through self-guided interventions.

3. Digital psychotherapy

Evidence-based psychotherapy interventions that were once accessible only through human therapists are now provided by therapy chatbots. Through scheduled dialogue sessions available around the clock from anywhere, these AI systems offer dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), and cognitive behavioral therapy (CBT). 

Important benefits include rapid accessibility without scheduling restrictions, a constant delivery of therapy regimens, and anonymity for patients uncomfortable addressing delicate subjects in person. Although chatbots can’t completely replace human therapists in complex cases, they can provide structured interventions for disorders like OCD, depression, and anxiety, thereby opening up psychotherapy to disadvantaged communities that might not otherwise receive treatment.

Real-life example

The effectiveness of these tools has been clinically validated recently. For instance, a study conducted in December 2024 found that DBT-Guide significantly improved emotion regulation after six weeks, while Therabot’s “Resilience Builder” module utilizes generative AI to offer personalized mindfulness exercises that adapt based on wearable stress data and session feedback.

4. Progress monitoring & crisis prevention

Through automated check-ins and various data sources, therapy chatbots can facilitate ongoing patient monitoring. By using conversational interfaces on mobile apps or messaging platforms like WhatsApp, they keep track of adherence to therapeutic activities such as:

• Exercise regimens,
• Meditation techniques,
• Healthy eating habits,
• Mood journaling.

Patients receive gentle reminders and real-time feedback from this continuous monitoring, which promotes accountability and supports their recovery.

To address significant gaps in traditional therapy that often arise between scheduled appointments, this dual approach of progress tracking and crisis prevention ensures that patients receive both ongoing support for their recovery goals and immediate intervention when necessary.

Real-life example

Therabot’s safety policy promptly escalates high-risk discussions to human physicians or crisis hotlines when threshold evaluations of user inputs and voice biomarkers suggest possible self-harm. Advanced safety monitoring is a feature of modern systems that transcends simple tracking. Sentiment analysis, vocal stress indicators, and keystroke dynamics are now utilized by LLM-based bots to detect crisis situations early.

5. Life coaching & preventive mental health support

In addition to professional therapy, chatbots also provide life coaching services aimed at addressing lifestyle factors that impact mental health. Grounded in the principles of positive psychology, these systems help users improve their overall well-being and self-esteem, fostering resilience and reducing the risk of serious mental health challenges.

1. Lifestyle advice: Chatbots offer suggestions for mindfulness exercises (such as guided meditation and yoga instruction), healthy eating (including restaurant recommendations and recipes), fitness motivation (with workout programs and progress tracking), and socializing (featuring hobby-based activities and local events).
2. Community support management: Large peer-support forums are monitored and moderated by AI platforms, such as PeerAI, which utilize large language models (LLMs). These platforms eliminate hazardous content in real-time and direct users to evidence-based resources. Safe digital support environments that previously required extensive human moderation are now ensured.
3. Specialized populations: Specialized solutions often work in conjunction with healthcare systems to provide automated check-ins and notify professionals of concerning trends.
4. Group interventions: To make group therapy more approachable and organized, some platforms now offer AI-assisted group therapy sessions. These sessions include bots that regulate conversations, summarize themes for clinicians, and recommend discussion topics based on aggregate sentiment analysis.

Real-life example

Woebot Health’s FDA-approved postpartum depression treatment, WB001, combines interpersonal psychotherapy with cognitive behavioral therapy for new mothers. According to Wysa clinical research, mothers’ depressive symptoms decreased by 13%, and many of them moved from “moderately severe depression” to “moderate depression.” ²

What are therapist chatbots?

Therapist chatbots are AI-powered conversational tools designed to assist healthcare providers in supporting patients with psychiatric disorders, trauma, or stress.

Modern therapy bots have evolved beyond early rule-based systems to leverage large language models (LLMs) for generative conversational therapy, cognitive behavioral therapy (CBT), and Dialectical Behavior Therapy (DBT) interventions. Many now offer multimodal interfaces that process voice, video, facial expressions, and biosignals from wearables for personalized, context-aware support.

By March 27, 2025, Dartmouth’s “Therabot” became the first LLM-based therapy bot tested in a randomized controlled trial, showing depression and anxiety reductions comparable to in-person therapy.³ Meanwhile, platforms like Earkick have pioneered multimodal mood tracking with avatars that analyze voice tone, facial cues, and touch interactions, reporting a 34% mood improvement and a 32% reduction in anxiety over five months.⁴

Therefore, therapist chatbots currently include:

• Rule-based CBT/DBT bots (e.g., earlier versions of Woebot, Wysa).
• Generative LLM-powered bots (e.g., Therabot and ChatGPT-assisted integrations).
• Hybrid systems that merge conversational AI with clinician oversight and telehealth video.

How can chatbots combat the mental health treatment gap?

Therapy chatbots bridge the treatment gap using several interconnected methods to provide scalable mental health support without compromising clinical effectiveness:

• Immediate access and triage: Chatbots are available 24/7 for initial evaluations and interventions of low to moderate severity. They efficiently handle administrative responsibilities, such as onboarding and initial symptom assessments. This service decreases wait times for individuals on lengthy counseling lists and broadens access to underserved regions facing provider shortages.
• Clinical effectiveness: Recent research indicates substantial therapeutic results. Participants diagnosed with major depressive disorder reported a 51% decrease in symptoms within four weeks, whereas those with generalized anxiety experienced a 31% reduction. Additionally, the risk factors associated with eating disorders diminished by 19%. ⁵
• Integrated care delivery: Therapy bots connect with healthcare systems through EMR integration using FHIR APIs, enabling real-time progress sharing with licensed providers and automating the escalation of high-risk cases. Platforms such as Earkick improve this by providing ongoing biometric monitoring from wearables that identify acute stress episodes and offer timely interventions via push notifications or voice prompts.

This multi-layered approach enables clinicians to focus their expertise on complex cases, while chatbots handle routine support, effectively expanding the mental health workforce’s capacity.

What are the challenges of therapist chatbots?

If the challenges with therapy bots are not taken into account, a digital transformation project to cure more patients could be disastrous. Therefore, we want to highlight the top 4 challenges

1. False diagnosis

Chatbots can misdiagnose mental illnesses or overlook a disease. As they are designed to differentiate between critical and moderate cases to assist medical professionals, practitioners face a heightened risk of failing to accurately diagnose an ailment. Nonetheless, a person might never be evaluated by a human doctor if an AI algorithm classifies them as mild or healthy.⁶

2. False treatment

False treatment is another problem associated with therapy bots. If chatbots offer generic therapeutic procedures, they could jeopardize the health of some users. Consider a chatbot that provides dietary advice. Such a chatbot might advise users to limit their salt intake. However, this basic health advice can worsen a patient’s condition if he has low blood pressure.⁷

3. Technical failures & systemic risks

Therapy chatbots can encounter various failures that present serious risks to users, especially to vulnerable groups seeking mental health assistance.,

• Technical and communication limitations: Voice tone, syntax, and nonverbal cues like eye contact and fidgeting are difficult for chatbots to interpret. Trained doctors understand these indicators through various communication channels. Human emotions and compassionate care are beyond algorithmic capabilities. Research shows incorrect responses lead to user disinterest, and chatbots often fail to meet specific needs. Even seasoned therapists can miscommunicate based on their methods, and quantifying therapeutic efficacy remains largely unknown.⁸
• Bias: Prejudice in training data can lead to algorithmic bias, which can exacerbate mental health disorders, heighten discrimination against marginalized and ethnic minority groups, and provide individuals with harmful or incorrect advice. People from marginalized communities are often excluded from the design and development stages of these technologies, potentially resulting in them receiving unsuitable and biased outcomes. Research indicates that there have been cases where children and teenagers have interacted with chatbots impersonating certified therapists; one child even died by suicide due to extensive use of the program.⁹
• Overtrust and therapeutic misconception: Users may overestimate digital therapy’s benefits and underestimate its drawbacks, leading to a “therapeutic misconception” where they think they are improving their mental health while receiving subpar care. When chatbots fail to provide appropriate therapeutic assistance, users may overly trust them and share personal information. Despite attempts to mimic real-life interactions, mental health chatbots still cannot replicate the complex therapeutic bond that develops between patients and human specialists.¹⁰

4. Privacy & data security concerns

Chatbots for mental health collect highly sensitive personal data, which presents significant privacy risks that are often inadequately addressed by laws and industry standards.

• Data protection and regulatory gaps: To evade FDA regulation, most mental health apps avoid the “medical device” designation, leading to significant control gaps. According to APA experts, privacy abuses are serious issues that, without adequate oversight, could harm vulnerable individuals. Users are legally at risk since therapeutic conversations lack protection by therapeutic privilege under HIPAA. Given the sensitive nature of mental health discussions, current technologies cannot offer the exceptional data protection that is necessary.
• Vulnerable population exploitation: Users’ trust in healthcare systems is exploited by misleading marketing, especially when applications assert partnerships with therapists. This leads users to share personal health information without realizing who controls the data. Individuals from marginalized communities, who have limited access to mental health services, may be swayed to use these tools without fully grasping their risks. Other barriers to safe usage include financial constraints, privacy issues, and a reduced willingness among lower socioeconomic groups.
• Data mining and commercial exploitation: When systems may not provide appropriate therapeutic guidance, users disclose personal information and develop strong trust in chatbots. There is a lack of professional oversight in this rapidly growing industry, as clinical experts indicate they have not found any information regarding the use of therapeutic chatbots.¹¹

Top 5 therapist chatbot best practices

Strategies based on evidence can enhance therapeutic advantages while reducing risks highlighted by current research.

1. Human-in-the-loop oversight: Instead of using chatbots as stand-alone systems, implement them under clinical supervision. Research indicates that real-time human intervention capabilities are essential for therapy bots to be effective, especially in crises or when conversations reveal high-risk behaviors. Establish clear procedures for notifying certified mental health specialists when chatbots detect concerning trends or exceed their therapeutic limits.
2. Ensure transparent AI disclosure and limitation warnings: Clarify that the system is AI-powered, not human. Implement evidence-based strategies, like Woebot’s recurring reminders to users that “as smart as I may seem, I’m not capable of really understanding what you need.” Ensure quick access to human support services and include clear disclaimers about the limitations of crisis intervention.
3. Prioritize bias mitigation and inclusive design: Reduce algorithmic bias against minority populations by utilizing diverse training datasets and implementing fairness checks. To ensure culturally relevant solutions, involve underrepresented communities in the design and development process. Employ bias-detection tools and regularly assess chatbot outputs for discriminatory trends.
4. Focus on evidence-based therapeutic interventions: Install chatbots with pre-screened responses approved by certified clinicians that utilize validated therapeutic techniques such as CBT, DBT, or ACT. Avoid generative AI systems that might produce unpredictable results. Ensure all therapeutic materials are developed in collaboration with mental health professionals and are based on peer-reviewed psychological research.
5. Implement comprehensive privacy and security frameworks: Collaborating with suppliers who comply with GDPR, HIPAA, and other relevant data protection laws. Ensure that the same privacy safeguards applicable to regular treatment sessions also extend to therapeutic communications. Follow data minimization guidelines, clearly disclose data ownership in an understandable manner, and empower users with control over their personal data, including the ability to delete and transfer it.

Further reading

• AI in healthcare use cases
• AI applications in dermatology
• AI in radiology

External Links

• 1. Mental Illness & Mental Health Statistics Worldwide - Kutest Kids.
• 2. AI chatbot reduces depression in prenatal and postnatal women. Digital Health Intelligence
• 3. First Therapy Chatbot Trial Yields Mental Health Benefits | Dartmouth.
• 4. Earkick Unveils Evidence Supporting AI's Real-Time Impact on Mental Health Improvement. Business Wire
• 5. https://ai.nejm.org/doi/full/10.1056/AIoa2400802
• 6. AI Therapy Chatbots: Pros, Cons and Ethical Risks. Tech.co
• 7. Using generic AI chatbots for mental health support: A dangerous trend.
• 8. Therapy by AI holds promise and challenges : Shots - Health News : NPR. NPR
• 9. Your robot therapist is not your therapist: understanding the role of AI-powered mental health chatbots - PMC .
• 10. To chat or bot to chat: Ethical issues with using chatbots in mental health - Simon Coghlan, Kobi Leins, Susie Sheldrick, Marc Cheong, Piers Gooding, Simon D'Alfonso, 2023 .
• 11. My patients are teaching me about AI’s uses in therapy - The Washington Post. The Washington Post